Celiac Disease Risk Rises as People Age, Study in U.S. Shows

By Elizabeth Lopatto -
Sep 27, 2010

Celiac disease, which damages the
lining of the gut and is triggered by eating food containing
gluten, occurs more often as adults age, according to a study
suggesting that environmental influences may be involved.

Cases doubled in a sample of 3,511 patients followed from
1974 to 1989, according to proteins measured in blood samples.
This provides evidence that the condition doesn’t start in
childhood, as doctors once thought it did, researchers said
today in the Annals of Medicine.

The results may begin to explain why celiac disease has
increased fivefold in the U.S. in the last 30 years, the authors
wrote. The research suggests that the rise is not simply due to
better diagnosis, and that the illness may be preventable, as
people with a genetic disposition for it can live decades before
getting sick, said Alessio Fasano, an author of the study.

“If we can understand what helps people lose gluten
tolerance, we may develop tricks to retain tolerance, even if
you’ve lost it already,” said Fasano, director of the
University of Maryland’s Mucosal Biology Research Center in
Baltimore and the celiac research center, in a telephone
interview.

Celiac disease affects more than 2 million Americans,
according to the National Institutes of Health, based in
Bethesda, Maryland. The condition, which can be symptomless, is
triggered when people ingest wheat or other foods containing
gluten, such as bread or beer. The immune system attacks part of
the small intestine, causing abdominal bloating, diarrhea,
vomiting, constipation, weight loss and pain, the federal agency
says on its website.

Autoimmune Disease

Because the illness is an autoimmune disease, the findings
may also hold clues to other disorders, such as multiple
sclerosis, that are caused by a malfunctioning immune system.

The report showing people may acquire celiac disease as
they age time strengthens the idea that the environment may be
crucial for developing the condition. Patients’ genes didn’t
vary during the study, Fasano said.

The effects of environment may be described by thinking of
the human genome as a piano, he said. As long as no one plays
the instrument, the owner doesn’t notice that some keys are
defective. If someone plays, suddenly the defect is obvious,
Fasano said. Perhaps the player in celiac disease is a virus or
bacterium, he said.

The study was done by testing blood samples taken in 1974
and 1989 from people in Washington County, Maryland, the authors
wrote.

Fasano plans to study people who develop celiac disease at
young ages and compare them with people who develop the disease
later, to see if there can be some pattern, he said.

The research was funded by the University of Maryland
School of Medicine, Madison, New Jersey-based Quest Diagnostics
Inc., and other sources.